AIM： To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation （RCI） in patients with fecal incon...AIM： To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation （RCI） in patients with fecal incontinence or constipation.METHODS： Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire.RESULTS： Of the 201 patients （93 adults, 108 children）, 101 （50%） responded. Adults： anal plugs （8）, five stopped immediately, one stopped after 20 mo and two used it for 12-15 too. RCl （40, 28 fecal incontinence, 12 constipation）, 63% are still using it （mean 8.5 years）, 88% was satisfied. Younger adults （〈 40 years） were more satisfied with RCI （94 % vs 65%, P = 0.05）. Children： anal plugs （7）, 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI （26 fecal incontinence, 22 constipation）, 90% are still using it （mean time 6.8 years） and felt satisfied. Children tend to be more satisfied （P = 0.001）. Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation.CONCLUSION： RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.展开更多
AIM： To describe the characteristics of Dutch patients with chronic.inflammatory bowel disease （IBD） first diagnosed above 60 years of age-a disease also known as old-age colitis （OAC） and to highlight a conditio...AIM： To describe the characteristics of Dutch patients with chronic.inflammatory bowel disease （IBD） first diagnosed above 60 years of age-a disease also known as old-age colitis （OAC） and to highlight a condition that has a similar appearance to IBD, namely segmen- tal colitis associated with diverticular disease （SCAD）. METHODS： A retrospective longitudinal survey of patient demographic and clinical characteristics, disease characteristics, diagnostic methods, management and course of disease was performed. The median follow-up period was 10 years. RESULTS： Of a total of 1100 IBD patients attending the Department of Gastroenterology, 59 （50） [median age 82 years （range 64-101）; 25 male （42%）] were identified. These patients were diagnosed with ulcerative colitis （n = 37, 61%）, Crohn＇s disease （n = 14, 24%）, and indeterminate colitis （n = 8, 15%）. Remission was induced in 40 （68%） patients within a median interval of 6 mo （range 1-21） and immunosuppressive therapy was well tolerated. Histological evaluation based on many biopsy samples and the course of the disease led to other diagnosis, namely SCAD instead of IBD in five （8%） patients. CONCLUSION： OAC is not an infrequent problem for the gastroenterologist, and should be considered in the evaluation of older patients with clinical features suggestive of IBD. Extra awareness and extensive biopsy sampling are required in order to avoid an erroneous diagnosis purely based on histological mimicry of changes seen in SCAD, when diagnosing IBD in the presence of diverticulosis coli.展开更多
文摘AIM： To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation （RCI） in patients with fecal incontinence or constipation.METHODS： Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire.RESULTS： Of the 201 patients （93 adults, 108 children）, 101 （50%） responded. Adults： anal plugs （8）, five stopped immediately, one stopped after 20 mo and two used it for 12-15 too. RCl （40, 28 fecal incontinence, 12 constipation）, 63% are still using it （mean 8.5 years）, 88% was satisfied. Younger adults （〈 40 years） were more satisfied with RCI （94 % vs 65%, P = 0.05）. Children： anal plugs （7）, 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI （26 fecal incontinence, 22 constipation）, 90% are still using it （mean time 6.8 years） and felt satisfied. Children tend to be more satisfied （P = 0.001）. Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation.CONCLUSION： RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.
文摘AIM： To describe the characteristics of Dutch patients with chronic.inflammatory bowel disease （IBD） first diagnosed above 60 years of age-a disease also known as old-age colitis （OAC） and to highlight a condition that has a similar appearance to IBD, namely segmen- tal colitis associated with diverticular disease （SCAD）. METHODS： A retrospective longitudinal survey of patient demographic and clinical characteristics, disease characteristics, diagnostic methods, management and course of disease was performed. The median follow-up period was 10 years. RESULTS： Of a total of 1100 IBD patients attending the Department of Gastroenterology, 59 （50） [median age 82 years （range 64-101）; 25 male （42%）] were identified. These patients were diagnosed with ulcerative colitis （n = 37, 61%）, Crohn＇s disease （n = 14, 24%）, and indeterminate colitis （n = 8, 15%）. Remission was induced in 40 （68%） patients within a median interval of 6 mo （range 1-21） and immunosuppressive therapy was well tolerated. Histological evaluation based on many biopsy samples and the course of the disease led to other diagnosis, namely SCAD instead of IBD in five （8%） patients. CONCLUSION： OAC is not an infrequent problem for the gastroenterologist, and should be considered in the evaluation of older patients with clinical features suggestive of IBD. Extra awareness and extensive biopsy sampling are required in order to avoid an erroneous diagnosis purely based on histological mimicry of changes seen in SCAD, when diagnosing IBD in the presence of diverticulosis coli.
